Basic Information
| Provider Information | |||||||||
| NPI: | 1205818465 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | WESTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 9300 VALLEY CHILDREN'S PL | ||||||||
| Address2: | SC05 | ||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593535714 | ||||||||
| FaxNumber: | 5593535708 | ||||||||
| Practice Location | |||||||||
| Address1: | 9300 VALLEY CHILDREN'S PL | ||||||||
| Address2: | FE16 | ||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593536700 | ||||||||
| FaxNumber: | 5593536710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2005 | ||||||||
| LastUpdateDate: | 01/06/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 20A17508 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 09033767 | 05 | MS | MEDICAID | 226663 | 01 | PA | JOHNS HOPKINS | OTHER | 55603 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 895187 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 258758 | 01 | PA | UNISON-WMG | OTHER | 30139633 | 01 | PA | AMERIHEALTH MERCY-YHOBGYN | OTHER | 51546504 | 01 | AL | BCBS - 1707 CENTER ST., STE 102 | OTHER | 280819 | 01 | PA | UNISON-YHCHC | OTHER | 945886 | 01 | MD | CAREFIRST MD BCBS | OTHER | 20086844 | 01 | PA | AMERIHEALTH MERCY | OTHER | 20087482 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 001638195 | 05 | PA | MEDICAID | 1504289 | 01 | PA | GATEWAY-WMG | OTHER | 50082457 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 100244 | 05 | AL | MEDICAID | 20091823 | 01 | PA | AMERIHEALTH MERCY-YH | OTHER |